Dipping Pattern and 1-year stroke functional outcome in ischemic stroke or transient ischemic attack

ABSTRACT

Aims

This study aimed to explore whether a relationship exists between dipping patterns and 1-year functional outcome in patients with acute ischemic stroke (IS) or transient ischemic attack (TIA).

Methods

Data from the Blood Pressure and Clinical Outcome in TIA or Ischemic Stroke Study (BOSS), a nationwide, hospital-based, longitudinal cohort study, was used for this study. Patients with acute IS or TIA were recruited within 7 days after onset and ambulatory blood pressure monitoring was performed during hospitalization. Patients were defined as dippers if nocturnal systolic blood pressure fell by ≥10%, non-dippers if 0–10%, and reverse dippers if < 0%. Poor functional outcome was defined as a modified Rankin Scale (mRS) score of 3–5. Logistic regression analysis was used to test the association between dipping patterns and 1-year functional outcome.

Results

Among the 1808 IS/TIA patients, 19.19% were dippers, 53.21% were non-dippers, and 27.60% were reverse dippers. Poor functional outcome occurred in 22.44% of reverse dippers, which was significantly higher than that of dippers (16.14%) and non-dippers (16.53%) (P = .014). A univariate analysis revealed that reverse dipping was a risk factor for poor functional outcome (Odds ratio 1.504, 95% confidence interval 1.055–2.145, P = .024). However, this significance disappeared after adjusting for confounders.

Conclusions

Reverse dipping was prevalent in patients with IS/TIA. The higher incidence of 1-year poor functional outcome in reverse dippers warrants further investigation.

KEYWORDS:

• Dipping pattern
• reverse dipping
• acute ischemic stroke
• transient ischemic attack
• functional outcome

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10641963.2022.2139384

Additional information

Funding

This study was supported by grants from the Ministry of Science and Technology of the Peoples Republic of China (2011BAI08B01, 2013BAI09B02, 2017YFC1310901, 2017YFC1310902, 2016YFC0901001, 2016YFC0901002, 2018YFC1311700, and 2018YFC1311706), a grant from Beijing Municipal Administration of Hospitals’ Youth Program (QML20150504), grants from the Beijing Municipal Commission of Health and Family Planning (No.2016-1-2041, SML20150502), Beijing Multiple Administration of Hospital Clinical Medicine Development of Special Funding Support (ZYLX201820), Beijing Health Scientific and Technological Achievements, and appropriate technology promotion projects (2018-TG-32).